Claims Information

Our team can help you:

1. Decide on which facility to attend to receive the best quality treatment
2. Keep claims costs down
3. Put the bill on our card instead of yours
4. Get pre-approval of planned treatment

In the USA, Talent Trust recommends costplusdrugs.com to source your medication where it is available.

What is Pre-authorization?

Certain treatments require you to get pre-authorization by requiring you to submit a Pre-authorization Form in advance. Pre-authorization may also be known as treatment guarantee, pre-approval, or prior authorization by some medical providers.

Following approval, cover for these required treatments or costs can then be guaranteed.

Which Treatments Require Pre-authorization?

• The following items will require pre-authorization:
• Planned inpatient or day patient treatment (hospitalization)
• Any pregnancy or childbirth treatment
• Planned surgery (including outpatient surgery)
• Evacuation
• Psychiatric treatment -inpatient or day patient
• Home nursing charges
• Planned inpatient, day patient or outpatient PET & CT-PET scans
• Planned outpatient treatment above US$1,000

The pre-approval process helps to assess each case, organize everything with the hospital before your arrival, and make direct payment of your hospital bill easier, where possible.

How does the Pre-authorization Process Work?

1. First, check if your plan covers the treatment you are seeking. Your Table of Benefits will confirm which benefits are available to you. If you are unsure, please email us with your policy number and we can help you.

2. Download the Pre-authorization Form. The form must be fully completed by you and your physician.

3. Send the completed form to us for approval at least 5 working days before your planned treatment to medicassist@talent-trust.com

4. We will respond within 24 hours of receiving a fully completed form.

5. We will then contact your medical provider directly to arrange settlement of your bills.

Do I Need Pre-authorization in Emergency Situations?

In case of emergencies, immediately get the emergency treatment you need. Call the 24/7 Helpline +1 (800) 495-5099 if you need advice or sup-
port.

If you are hospitalised, either you, your doctor, one of your dependants or a colleague needs to call the 24/7 Helpline within 48 hours of the emergency to inform us of the hospitalisation. We can take Pre-Authorization Form details over the phone when you call us. However, coverage for emergency medical costs are subject to the terms of your health plan.

What are the Benefits of Pre-authorization?

The pre-authorization process gives us the opportunity to assess whether a treatment recommended to you is medically necessary, and at a reasonable cost.

Preapproval also:

• Ensures your planned treatment is covered under your plan. In the case of an evacuation/repatriation, we will organise and co-ordinate this on your behalf – so you can focus on getting better.
• Keeps out-of-pocket expenses in check. In many cases, we’ll be able to settle your bill directly with the provider.

Why is Pre-authorization Necessary?

It is important that you submit a Pre-authorization Form where required, prior to treatment, as we reserve the right to decline a claim or apply a penalty if this process is not followed.

It’s always a good idea to double check your benefits before receiving any non-emergency medical care, to ensure that you know your plan’s pre-approval requirements. If you are in doubt, contact us in advance of obtaining your treatment.

Please settle your bills first and then submit your completed claims form, receipts, invoices, copies of any investigation report and pharmacy prescription (if applicable) to Talent Trust by emailing to claims@talent-trust.com. You may also use a smartphone to take a photo of the documents.

Please comply with the following guidelines when submitting prepaid claims for reimbursement:

1. Attachments must be readable.
2. Our recommended file formats are PDF, JPG or JPEG.
3. Please do not submit claims for more than 1 condition or person in a single email. If you have multiple claims, please put these in separate emails.
4. The maximum size for a single email with attachments should not be larger than 8 MB.
5. To ensure prompt reimbursement of eligible prepaid claims, please ensure that you submit all necessary claim documents for processing.

It is rarely necessary for your to submit your original documents by post, but it is recommended that you keep them until your claim is settled.

Travel Claims (Non-medical)

Please fill out only the relevant sections of the Travel Claim Form and ensure all necessary supporting information is attached. Please refer to the Claim Check List on the back of the Travel Claim Form for the different kinds of travel claims:

• Cancellation
• Curtailment
• Lost Luggage
• Luggage Delay
• Stolen Articles
• Lost or Stolen Notebook Computer, Camera, or Musical Instrument
• Lost or Stolen Personal Money
• Lost or Stolen Passport

Email claims forms to: claims@talent-trust.com